Loss of resources and demoralization in the chronically ill

TY - JOUR

T1 - Loss of resources and demoralization in the chronically ill

AU - Dischinger, M I

AU - Lange, L

AU - Vehling, S

N1 - Copyright © 2019 Elsevier Inc. All rights reserved.

PY - 2019/9/14

Y1 - 2019/9/14

N2 - OBJECTIVE: The study examined whether the association between the severity of physical symptoms and demoralization is mediated by loss of resources in individuals with chronic conditions including conventional diagnoses, functional somatic syndromes, and medically unexplained symptoms.METHOD: This cross-sectional study evaluated N = 194 patients (mean age = 46, 83.5% female) who reported at least 3 months of persistent physical symptoms using the following self-report instruments: PHQ-15 (modified), Loss of Resources Inventory, Psychosocial Questionnaire - Demoralization Subscale, and PHQ-8. The mediation hypothesis was tested by multiple regression analyses controlling for age, race, employment status, income, educational attainment, and depression.RESULTS: Participants experienced M = 9.3 out of 16 possible health-related losses (SD = 4.4). Average to severe demoralization scores were indicated by 59.1% of individuals, of which only 17.1% experienced high demoralization. Loss of resources fully mediated the effect of symptom severity on demoralization, explaining 56% of the variance of demoralization and inhibiting the initially significant effect of symptom severity on demoralization to nonsignificant levels [from b = 0.67, 95% CI (0.26, 1.07) to b = 0.03, 95% CI (-0.27, 0.32)].CONCLUSION: Early recognition of the loss of resources phenomena and interventions to reduce its progression through the introduction of resource gains may diminish, or even prevent, the installation of demoralization in individuals with chronic symptoms.

AB - OBJECTIVE: The study examined whether the association between the severity of physical symptoms and demoralization is mediated by loss of resources in individuals with chronic conditions including conventional diagnoses, functional somatic syndromes, and medically unexplained symptoms.METHOD: This cross-sectional study evaluated N = 194 patients (mean age = 46, 83.5% female) who reported at least 3 months of persistent physical symptoms using the following self-report instruments: PHQ-15 (modified), Loss of Resources Inventory, Psychosocial Questionnaire - Demoralization Subscale, and PHQ-8. The mediation hypothesis was tested by multiple regression analyses controlling for age, race, employment status, income, educational attainment, and depression.RESULTS: Participants experienced M = 9.3 out of 16 possible health-related losses (SD = 4.4). Average to severe demoralization scores were indicated by 59.1% of individuals, of which only 17.1% experienced high demoralization. Loss of resources fully mediated the effect of symptom severity on demoralization, explaining 56% of the variance of demoralization and inhibiting the initially significant effect of symptom severity on demoralization to nonsignificant levels [from b = 0.67, 95% CI (0.26, 1.07) to b = 0.03, 95% CI (-0.27, 0.32)].CONCLUSION: Early recognition of the loss of resources phenomena and interventions to reduce its progression through the introduction of resource gains may diminish, or even prevent, the installation of demoralization in individuals with chronic symptoms.

KW - Adaptation, Psychological

KW - Adult

KW - Chronic Disease/psychology

KW - Cross-Sectional Studies

KW - Demoralization

KW - Female

KW - Humans

KW - Male

KW - Medically Unexplained Symptoms

KW - Middle Aged

KW - Quality of Life/psychology

KW - Severity of Illness Index

KW - Socioeconomic Factors

KW - Somatoform Disorders/psychology

U2 - 10.1016/j.genhosppsych.2019.08.002

DO - 10.1016/j.genhosppsych.2019.08.002

M3 - SCORING: Journal article

C2 - 31518884

VL - 61

SP - 10

EP - 15

JO - GEN HOSP PSYCHIAT

JF - GEN HOSP PSYCHIAT

SN - 0163-8343

ER -